Estimating the Cost of Illness in Colorectal Cancer Patients Who Were Hospitalized for Severe Chemotherapy-Induced Diarrhea
Bibliographic record
Abstract
BACKGROUND: Previous studies have suggested that grade III/IV diarrhea is a common complication in colorectal cancer, occurring in 20% to 30% of patients receiving chemotherapy. In some of these patients, hospitalization for supportive care is often required. However, the impact that these hospitalized patients have on overall use of health care resources has not been quantified. In the present study, a cost of illness analysis was conducted to estimate the overall cost of patients with colorectal cancer who were hospitalized for supportive care secondary to severe diarrhea. METHODS: This was a retrospective cohort study consisting of patients with colorectal cancer that had received fluoropyrimidines, irinotecan or oxaliplatin (or a combination thereof) and had developed grade III or IV diarrhea that resulted in hospital admission for supportive care. Data collection included patient demographics, disease-related information and use of health care resources to manage the grade III/IV diarrhea event. RESULTS: Patients had a mean age of 64.2 years, and 32 of 63 (50.8%) were receiving adjuvant chemotherapy with a curative intent. The severe diarrhea developed after the first cycle of chemotherapy in 58% of the patients and contributed to a dose reduction, change or discontinuation of chemotherapy in 9.5%, 15.9% and 34.2% of patients, respectively. Overall, the median length of hospital stay was eight days (range one to 49 days) translating to a mean cost of $8,230 per patient (95% CI $6,519 to $9,942). The diarrhea successfully resolved in 54 of 63 patients (85.7%). CONCLUSIONS: Severe diarrhea requiring hospital admission is a costly and potentially fatal complication of chemotherapy in colorectal cancer. The identification of predictive factors and the implementation of prophylactic measures could reduce the morbidity and mortality associated with diarrhea.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".